Lee: Medical ‘safety net’ first step toward health equity for Arizona’s uninsured

What would health care look like if providers collaborated to offer their patients more comprehensive and improved quality care? I can tell you, first hand, it would look a lot like Teresa. Dr. Maurice Lee In October 2018, Teresa came to the Virginia G. Piper Medical & Dental Clinic at St. Vincent de Paul for odd abdominal symptoms. It had been eight years since her last pap smear, and it was painfully obvious she had cancer as soon as I saw the large mass on her cervix. Cervical cancer at age 37. Single mother of five. Uninsured. What next? Many uninsured individuals, like Teresa, would have gone undiagnosed until the cancer was incurable. But thanks to the free clinic at St. Vincent de Paul, she had access to care that was amplified and strengthened by the clinic’s leadership in the Arizona Safety Net --- a collaboration of local health organizations to share resources, best practices and partner in treatment. Our team, along with the Wesley Health Center, LabCorp, SimonMed and the Southwest Oncology Centers, coordinated Teresa’s biopsy, excisional procedure and imaging needed for a definitive cervical cancer diagnosis at a total cost of $40. Teresa was expedited through gynoncology and received a plan for chemotherapy and radiation. She received a port placed for chemotherapy through charity care, and a physician has agreed to provide her radiation free of charge. Historically, uninsured patients clinic hop, looking for answers and only getting ‘band-aid’ treatments. They visit a number of primary care clinics, urgent cares and emergency rooms racking up bills that could have been avoided.

Creating health equity for the uninsured through collaboration and resource sharing is what strengthens the individual free and low cost clinics, which is why I chose to spearhead and form the Arizona Safety Net, breaking the charity and private healthcare stereotype of operating only within its own system.

I believe in a sharing model. The Arizona Safety Net may be the only of its kind in Arizona where patients and resources are not hoarded within a single system. What results is the best possible care for the patient, regardless of where the patient started. It also prevents “patient dumping” and complacency by providers offering substandard care despite knowing of and having better resources available. In its third year, the Arizona Safety Net has grown to include 10 healthcare systems with 43 individual clinics serving more than 37,000 patients and completing 155,000 visits annually. The relationships formed between clinics allow patients access to more than 20 areas of specialty care, advanced diagnostics/procedures and lifesaving medications. Teresa has a battle with cancer ahead. That battle shouldn’t include worrying about where she will get care. Now, she can look forward to a future with her children as opposed to planning a future for her children that she will not be a part of. Arizona Safety Net clinics see patients like Teresa every day. Thanks to a community of healing, uninsured patients shouldn’t have to clinic hop ever again, saving them money while also saving their lives. Editor’s Note: Dr. Maurice Lee is the Chief Medical Officer at the Virginia G. Piper Medical & Dental Clinic at St. Vincent de Paul.